Ersrunner Should I Reinstate

[Ersrunner]

I’m currently debating on reinstating citalopram after being off for 2 months. I started taking 20 mg of citalopram in 2016. Over the course of that year I experienced increased family issues and moved up to eventually taking 40mg by May 2017. I decided in November 2022 to start tapering and did so before finding this site. I dropped from 40 to 30 to 20 to 10 to 0 in only 4 weeks. I suffered horrible physical withdrawal side effects but that’s nothing compared to the now mental side effects I’m experiencing.  I wake up with my heart pounding a nervous wreck most mornings. Some days I calm down but most days I feel nervous all day. Then on top of that I have intrusive thoughts that induce panic. I’m miserable during these moments. I realize I wrecked my central nervous system. Would it be worth reinstating at 5 mg to try to settle everything out? It’s been 2 months since my last dose. 

[Altostrata]

Welcome, @Ersrunner

 

I understand you've been off citalopram only since November? Those symptoms do sound like protracted withdrawal syndrome.

 

If I were you, I'd get citalopram liquid by prescription and take only 1mg to start, see how you feel. If it helps a little at first, that may be all you need. You can taper by tiny amounts later. Please let us know how you're doing.

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

[Ersrunner]

Thank you! Do I just ask my doctor for the liquid prescription? I’m just under the care of a general practitioner. He is definitely not familiar with correct tapering. He told me to start back on 5 mg. I’ve done that the past 2 nights and have felt awful waking up. Im thinking 5 may have been too much for my system. 

[Altostrata]

Suggest you cut the tablet in half to take 2.5mg and ask him for the prescription liquid so you can titrate. I would not discuss tapering with him, he probably will not understand why you'd want to take a lower dose. 

How do you talk to a doctor about tapering and withdrawal?
 

For background, see Tips for tapering off citalopram (Celexa)

 

[Ersrunner]

Titled:  Cross Tapering

 

Hi!  

   I went off celexa in November way too quickly and had horrible withdrawal. I  reinstated in February at 20mg. My body settled out some but I was still struggling.  After a month my psychiatrist recommended switching to Lexapro.  I started lexepro at 10mg and dropped citalopram to 10.  This set me into a horrible onset of unbearable anxiety symptoms.  Physical and mental.  It's been 2 weeks with no improvement.  My psychiatrist is now recommending dropping citalopram all together and bumping up lexapro to 15.  I'm terrified to make such a big jump off citalopram.  I feel like everything I read says go slow.  Just wanted your input.  She seems to think that neither medication is at a therapeutic level.  

Edited March 11, 2023 by manymoretodays
merged from tapering forum

[manymoretodays]

Hey there, @Ersrunner This is your topic, and where to post when you come in.

Already I can see the value of keeping your posts here.

 

Just how did you do that gradual reinstatement of celexa/citalopram? 

Did you get the liquid and rapidly keep on going up to 20 mg?

28 minutes ago, Ersrunner said:

 I started lexepro at 10mg and dropped citalopram to 10.  This set me into a horrible onset of unbearable anxiety symptoms.  Physical and mental.  It's been 2 weeks with no improvement

 

This is no good.  You are getting too much now I think.

 

Can you back down on the Lexapro now?  What form do you have?

 

Tips for tapering Lexapro(escitalopram)   Please read the "Special Considerations" section, as well as how to get dosages that could help you back down on the Lexapro, and taper off of it.

 

I'm no genius, but I think you could be getting the effects of over-medication right now.  Too much.

 

When possible, please update your signature with these massive changes, dates, drugs, doses.  Here

 

And in your next reply here, attempt to give us a day, 24 hours.

Note the day, then note the times on the left periodically, and then note your drug intake by name of drug and dose on the right of the time.  As well as to the right of those times be noting your symptoms too.  Rate your unbearable anxiety with 1 being barely to 10 being extreme.

 

More on that here, as to how to do that:

Daily drug and symptom log

 

Hang in there Ersrunner.   Give us back what you can.  Sending safety and healing.

 

L, P, H, and G,

mmt

[Altostrata]

1 hour ago, Ersrunner said:

After a month my psychiatrist recommended switching to Lexapro.  I started lexepro at 10mg and dropped citalopram to 10.  This set me into a horrible onset of unbearable anxiety symptoms.  Physical and mental.  It's been 2 weeks with no improvement.

 

Hello, @Ersrunner You are now taking 10mg Lexapro and 10mg Celexa? Milligram for milligram, Lexapro is a stronger drug, so you are taking the equivalent of more than 30mg Celexa. Your symptoms indicate this is too strong for you or you are having an adverse reaction to Lexapro, and your psychiatrist is a fool for wanting to increase Lexapro further.

 

If I were you, I'd fire this psychiatrist and get my 20mg Celexa prescription from my GP. Sometimes recovery from reinstatement takes a while, you probably need longer than a month to stabilize on 20mg Celexa.

 

However, we offer peer support for going off drugs, and since you are under the active care of a psychiatrist and following instructions to increase your drugs, I have to ask you to take your questions about your new drug regimen to your psychiatrist, not to us.

[Ersrunner]

My goal is to get off medication. Her advice was that lexapro would be easier to come off. I definitely am losing trust in her advice. Do you think I’ll even out faster by just going back on citalopram at 20? I’ve only been on lexapro for 2 weeks. Will it cause withdrawal? I’m miserable. I’d rather just get back on 20 citalopram and titrate if very very slowly. 

[Altostrata]

Lexapro is not easier to go off than citalopram, and its introduction has already been a failure. We prefer to reinstate the dog that bit you. You can go right back to 20mg citalopram and drop the Lexapro. Your decision.

[Onmyway]

8 hours ago, Ersrunner said:

My goal is to get off medication. Her advice was that lexapro would be easier to come off. I definitely am losing trust in her advice. Do you think I’ll even out faster by just going back on citalopram at 20? I’ve only been on lexapro for 2 weeks. Will it cause withdrawal? I’m miserable. I’d rather just get back on 20 citalopram and titrate if very very slowly. 

@Ersrunner

your doctor is an idiot and incompetent plain and simple. Moving to escitalopram is not helping you as they are more or less the same. Except escitalopram has a shorter half life and so is harder to get off of. 

 

Citalopram is a chemical that is composed of two stereoisomers R-citalopram and S-citalopram - two molecules that are mirror images of each other. Escitalopram contains only the S-citalopram stereoisomer and does not have any R-citalopram. It is believed that the S-citalopram is the part that "works" and R-citalopram is no better than a filler. Also, escitalopram was introduced because the patent was running out on citalopram. 

 

Escitalopram is double (and more) the strength of citalopram as Alto mentioned above so 10mg escitalopram is more or less equivalent to 20mg citalopram. 

 

Now citalopram impacts your heart and in high doses is dangerous for your heart - esp above 40mg citalopram and 20mg escitalopram. You are getting closer to that level. 

 

We advised you here to reintroduce 1mg. 1mg reinstatements often achieve the same effect of alleviating withdrawal effects but not causing harm to the nervous system such as extra activation (anxiety, restlessness). And it's much easier to come off of 1mg than off of 20mg. 

 

You didn't listen to us. You don't have. But beware this doctor! 

 

OMW 

[Ersrunner]

Coming here for an update and advice. After a too fast taper off 40 mg of citalopram 2 years ago…I was cross tapered to Lexapro to help deal with the severs protracted withdrawal. That was a nightmare that I survived. I’m still in the windows and waves pattern on the 15 mg of Lexapro that  I was switched to. I want to start tapering the Lexapro but I’m not sure if I should considering I’m still in those patterns. When I do taper,  I plan to use the 10% method. I’m wondering if the Lexapro could be causing some of the symptoms I’m still experiencing considering it wasn’t  the original drug that I came off of too quickly. Intrusive thoughts being the most difficult symptom  to deal with.